The 76 studies were selected from 99 studies on the topic from Medline and Psyclit. Criteria for inclusion included cocaine use during pregnancy, human participants, neurobehavioral measures, original research, the inclusion or a control or comparison group, statistical analysis of the data, and publication in a peer-reviewed or refereed journal. The entries in the database noted study characteristics such as sample size and the method of drug detection, as well as behavioral outcomes such as the IQ score. The database demonstrated that the knowledge base on this topic is limited, scattered, and compromised by methodological problems that limit any conclusions about whether or not or how prenatal cocaine exposure affects child outcome. Only a few studies have followed children beyond age 3 years. In addition, the cocaine problem is more complicated than first envisioned. It is a multifactorial problem that includes the use of other drugs and issues related to parenting and lifestyles. In addition, the effects of prenatal cocaine exposure are probably more subtle than first anticipated. In general, the studies have not been able to determine if cocaine affects the child's development when confounding drug and context factors are explained. Larger samples, attention to mediator variables such as low birthweight, and consistent measures across studies are needed. Figures, tables, and 76 references